INCLUSION CRITERIA:
Age: Participants will be males and females, 18-50 years of age.
IQ: IQ, as measured by 4 subscales from the Wechsler Adult Intelligence Scale-Revised (WAIS-R), must be greater than 80.
Medication status: No regular use of psychotropic medication within 2 weeks of the study (or fluoxetine within 8 weeks of the study). No regular use of any benzodiazepine. We intend to identify patients whose GAD/SAD is currently untreated.
EXCLUSION CRITERIA:
Because factors such as psychiatric disease, or CNS disease, can influence functional brain activity, and pregnancy precludes participation in fMRI studies, these factors are exclusionary.
(1) Psychiatric history: Participants will be assessed using DSM-IV criteria via standardized psychiatric interviews conducted by trained examiners (i.e., SCID). Any current suicidal ideation will be exclusionary.
a. Healthy comparison individuals (Group 1): All participants will be free of any current psychiatric disorder as well as lifetime history of psychosis, pervasive developmental disorder, major affective disorder, panic disorder, obsessive compulsive disorder, ADHD, anorexia.
b. Patients with GAD (Group 2): Any history of an axis I diagnosis including SAD but not including adjustment disorder, simple phobia or dysthymia is exclusionary. There must be no current mood disorder (MD) though patients with past MD, which occurred after the onset of GAD, will be admitted to the study.
c. Patients with SAD (Group 3): Any current history of an axis I diagnosis apart from GAD and mood disorder (MD) but not including adjustment disorder, simple phobia or dysthymia is exclusionary. Participants will be excluded if the patient's MD preceded their SAD. We recognize the difficulty of recruiting patients with SAD without co-morbid GAD and will therefore allow patients who are comorbid into the study in this group.
(2) History of Drug Abuse: Axis I diagnoses of substance use disorders will be exclusionary.
(3) Severe acute and chronic medical illnesses.
(4) CNS disease: History of brain abnormalities (e.g., neoplasms, subarachnoid cysts), cerebrovascular disease, infectious disease (e.g., abscess), or other neurological disease, or history of head trauma (defined as a loss of consciousness greater than 3 min).
(5) Metal or electronic objects: Metal plates, certain types of dental braces, cardiac pacemakers, etc., that are sensitive to electromagnetic fields contraindicate MRI scans.
(6) Claustrophobia: Participants will be questioned about potential discomfort in being in an enclosed space, such as an MRI scanner.
(7) Pregnancy status: Because of the potential effects of hormonal changes on brain function as well as the unknown effects of electromagnetic field on the fetus, known pregnancy is an exclusion criterion.
National Institutes of Health Clinical Center
Bethesda, Maryland 20892. Last update: 01/13/2009